| C. The policy must meet the requirements for mandated | benefits under this Title applicable to small group health | plans. |
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| D.__Notwithstanding subsection 2, paragraph D, a carrier | may offer an additional discount of up to 20% of the | premium rate for the policy based on an individual's | weight or adherence to a recommended schedule for regular | physicals. With respect to weight and regular physicals, | the discount must be based on the individual's compliance | with the Centers for Disease Control and Prevention | guidelines in effect on the year of issuance or renewal of | the policy. |
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| E.__If approved by the superintendent, the policy may | include provisions with financial incentives encouraging a | policyholder to receive health care services at a center | of excellence or other high-quality provider designated by | the carrier based on objective quality indicators. |
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| Rules adopted pursuant to this subsection are routine | technical rules as defined in Title 5, chapter 375, subchapter | 2-A. |
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| | Sec. A-3. 24-A MRSA §4315 is enacted to read: |
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| §4315.__Primary health care policy |
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| | 1.__Mandatory offer.__A carrier offering a health plan in | this State shall offer and actively market a primary health | care policy, referred to in this section as "the policy," to | individuals and groups regardless of size.__The superintendent | shall adopt rules that define the benefit design for the | policy in accordance with the following. |
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| A. The policy must provide coverage that emphasizes | primary and preventive care, including, but not limited | to, well-adult and well-child visits and health | screenings. |
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| B. The annual maximum limit payable on the policy per | individual covered under the health plan, including | dependents, must be determined as follows: |
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| (1) For an individual whose income is between 100% | and 200% of the federal nonfarm income federal | poverty level, the annual maximum limit payable on | the policy is $2,000 per individual covered under the | policy; |
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| (2) For an individual whose income is between 200% | and 300% of the federal nonfarm income federal | poverty level, the annual maximum limit payable on | the policy is $5,000 per individual covered under the | policy; |
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